Fri Oct 07 2022

88 articles - From Friday Sep 30 2022 to Friday Oct 07 2022

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Guidelines

Guidelines, position statements, white papers, technical reviews, consensus statements, etc…

Endoscopy

Endoscopic diagnosis and management of esophagogastric variceal hemorrhage: European Society of Gastrointestinal Endoscopy (ESGE) Guideline.

16: ESGE recommends the use of NSBBs (propranolol or carvedilol) in combination with endoscopic therapy for secondary prophylaxis in EVH in patients with ACLD. Strong recommendation, high quality evidence.

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Meta-analysis

meta-analyses and systematic reviews

Neurogastroenterol Motil

Systematic review of small intestine pacing parameters for modulation of gut function.

Small intestine pacing shows therapeutic potential in treating disorders such as short bowel syndrome and obesity. This systematic review proposes standardized protocols to maximize research outcomes and thereby translate to human studies for clinical validation. The use of novel techniques such as high-resolution electrical, manometric, and optical mapping in future studies will enable a mechanistic understanding of pacing.

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Original articles

RCT, clinical trials, retrospective studies, etc…

Aliment Pharmacol Ther

Healthcare burden and outcomes of hepatorenal syndrome among cirrhosis-related hospitalisations in the US.

HRS was the cause of AKI in 16.5% of patients hospitalised with cirrhosis and conferred significant healthcare burden with 27,180 HRS hospitalisations in 2019 and requiring an estimated 4.2 billion USD for hospital care. While there has been a decrease in in-hospital mortality over time, it remained high at 23.7% in 2019 in those with HRS.

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Racial and ethnic differences in diet quality and food insecurity among adults with fatty liver and significant fibrosis: A U.S. population-based study.

Among adults with NAFLD, White persons had poorer DQ than other races/ethnicities. The influence of food insecurity on DQ may be potentiated in this group. Exploration of the sociocultural factors influencing DQ is needed to mitigate NAFLD disparities.

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Randomised controlled trial: effects of gluten-free diet on symptoms and the gut microenvironment in irritable bowel syndrome.

A gluten-free diet may influence symptoms in a subset of patients with IBS, with a particular effect on bowel habits. A gluten-free diet seems to impact the gut microenvironment. Responsiveness to the gluten-free diet may be predicted by the metabolite profile. NCT03869359.

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The inexorable increase of biological exposure in paediatric inflammatory bowel disease: a Scottish, population-based, longitudinal study.

Complete accrual of Scottish nationwide biologic usage within paediatric services demonstrates a rapidly changing, inexorably increasing PIBD biologics landscape.

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Treatment adaptations and outcomes of patients experiencing inflammatory bowel disease flares during the early COVID-19 pandemic: the PREPARE-IBD multicentre cohort study.

Despite treatment adaptations during the pandemic, steroid-free outcomes were comparable with pre-pandemic levels, although concurrent flare and suspected COVID-19 caused worse outcomes. These findings have implications for IBD management during future pandemics and for standard practice.

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Trends in characteristics, management, and outcomes of patients presenting with gastrointestinal bleeding to emergency departments in the United States from 2006 to 2019.

The incidence of GIB in the U.S. is increasing. UGIB incidence has been increasing since 2014 while LGIB incidence has been decreasing since 2015. Despite a more comorbid population in 2019, case fatality rate, length of stay and costs have decreased. More patients are discharged from the ED and the rate of RBC transfusions has decreased, possibly reflecting changing clinical practice in response to updated guidelines.

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Am J Gastroenterol

Caustic Ingestion: A Risk-Based Algorithm.

A risk-based algorithm could improve caustic ingestion management by maintaining high diagnostic accuracy while reducing diagnostic test requirements.

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Efficacy of traction device for endoscopic submucosal dissection using a scissor-type knife: Randomized controlled trial.

Whilst the resection rates were sufficiently high and adverse event rates were extremely low in both the groups, the use of a traction device for ESD in the proximal colon and for large lesions may increase the resection speed.

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Fecal calprotectin and quality of life questionnaires are responsive to change in pouch disease activity following antibiotic therapy-results from a prospective clinical trial.

FC and QoL questionnaires reflect real-time changes in inflammatory pouch activity.

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Placebo Adverse Events in Non-Alcoholic Steatohepatitis Clinical Trials. A Pooled Analysis of 2,944 Participants.

The present study summarizes the AEs with NASH placebo. Among participants in the placebo arm in NASH, two thirds experienced an AE, and nearly 10% experienced a serious AE..

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Rates of Antimicrobial Resistance in Helicobacter pylori Isolates from Clinical Trial Patients Across the US and Europe.

The resistance rates observed in this study argue against the continued empiric use of PPI-based triple therapy containing clarithromycin, per treatment guidelines, and highlight the need for antibiotic resistance surveillance and novel treatment strategies for H. pylori infection in the US and Europe.

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Results of a model of delivering hepatitis C care in a homeless metropolitan population in England.

Promoting education and having flexible and reflex "mobile" on-site-testing and treatment for HCV in the homeless population improves engagement with the healthcare system, meaning higher rates of treatment initiation and SVR. However, street-based homeless population not linked with harm reduction services are less likely to initiate HCV treatment, highlighting an urgent need for a broad health inclusion system.

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The Real-World Effectiveness and Safety of Ustekinumab in the Treatment of Crohn's Disease: Results from the SUCCESS Consortium.

UST represents a safe and effective treatment option for CD, with 40% of patients from a highly refractory cohort achieving clinical remission by 12 months. The greatest treatment effect of UST was seen in bio-naive patients, and dose escalation may recapture clinical response.

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Clin Gastroenterol Hepatol

ASSOCIATION OF CHRONIC PANCREATITIS PAIN FEATURES WITH PHYSICAL, MENTAL AND SOCIAL HEALTH.

Severe and constant pain are major drivers for poor psychological and physical health in CP. Systematic evaluation and management of psychiatric comorbidities and sleep disturbance should be incorporated into routine management of patients with CP. number-NCT03099850.

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Environmental Pollutants are Associated with Irritable Bowel Syndrome in a Commercially Insured Cohort of California Residents.

Exposure to PM2.5 and airborne toxic releases from facilities are associated with higher IBS incidence among a cohort of commercially-insured Californians. Environmental pollutant exposure was not associated with the incidence of IBD and EoE in this cohort.

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High-dimensional clustering of 4000 Irritable Bowel Syndrome Patients reveals Seven Distinct Disease Subsets.

In this cohort of older IBS patients, seven distinct clusters were identified demonstrating varying degrees of GI symptoms, comorbidities, dietary, and lifestyle factors. Further research is required to assess whether these unique clusters could be used to direct clinical trials and individualize patient management.

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The Spectrum and Impact of Metabolic Dysfunction in MAFLD. A Longitudinal Cohort Analysis of 32,683 Overweight and Obese Individuals.

This study reports on the heterogeneity and spectrum of metabolic dysfunction that exists in overweight and obese MAFLD. While MAFLD may be potentially be advantageous in improving awareness and patient outcomes, there remains substantial heterogeneity within patients included in MAFLD based on the underlying metabolic burden.

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Gastroenterology

Hepatocyte Adenosine Kinase Promotes Excessive Fat Deposition and Liver Inflammation.

Hepatocyte ADK functions to promote excessive fat deposition and liver inflammation through suppressing hepatocyte fatty acid oxidation and producing hepatocyte-derived proinflammatory mediators. Therefore, hepatocyte ADK is a therapeutic target for managing obesity and NAFLD.

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Unfermented ß-fructan fibers fuel inflammation in select inflammatory bowel disease patients.

While fibers are typically beneficial in individuals with normal microbial fermentative potential, some dietary fibers have detrimental effects in select patients with active IBD who lack fermentative microbe activities.

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Gastrointest Endosc

Quality indicators for capsule endoscopy and deep enteroscopy.

Comprehensive quality indicators have not existed for CE or DE. The task force identified quality indicators that can be incorporated into clinical practice. The panel also addressed existing knowledge gaps and posed research questions to better inform future research and quality guidelines for these procedures.

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Gut

Harnessing the Vnn1 pantetheinase pathway boosts short chain fatty acids production and mucosal protection in colitis.

Objective In the management of patients with IBD, there is a need to identify prognostic markers and druggable biological pathways to improve mucosal repair and probe the efficacy of tumour necrosis factor alpha biologics. Vnn1 is a pantetheinase that degrades pantetheine to pantothenate (vitamin B -driven metabolism should improve mucosal healing and might increase the efficacy of anti-inflammatory therapy.

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NOX1 is essential for TNFa-induced intestinal epithelial ROS secretion and inhibits M cell signatures.

NOX1 deficiency plus TNFa stimulation contribute to colitis through dysregulation of the stem cell niche and altered cell differentiation, enhancing basal lymphoplasmacytosis. Our findings prioritise ROS modulation for future therapies.

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TiO2 nanoparticles abrogate the protective effect of the Crohn's disease-associated variation within the PTPN22 gene locus.

We previously identified food-grade titanium dioxide (TiO nanoparticles might have adverse effects on the gastrointestinal health of individuals carrying the PTPN22 variant. This demonstrates that environmental factors interact with genetic risk variants and can reverse a protective mechanism into a disease-promoting effect.

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Hepatology

Clinicogenomic characteristics and synthetic lethal implications of germline homologous recombination-deficient HCC.

Our findings suggest that germline HR defects in HCC tend to confer a poor prognosis and result in distinctive genomic scarring. Tests of the clinical benefits of HR-directed treatments in the affected patients are needed.

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Emergence of highly profibrotic and proinflammatory Lrat+ Fbln2+ hepatic stellate cell subpopulation in alcoholic hepatitis.

A highly profibrotic, inflammatory, and immunoregulatory Lrat + Fbln2 + subpopulation emerges from HSCs in AH and may contribute to the inflammatory and immunoreactive nature of AH.

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J Hepatol

Third dose of COVID-19 mRNA vaccine appears to overcome vaccine hyporesponsiveness in patients with cirrhosis.

Administration of a third dose of a COVID-19 mRNA vaccine was associated with a more significant reduction in COVID-19 in cirrhosis than reported in the general population, suggesting that the third dose can overcome vaccine hyporesponsiveness in this population.

Pubmed   Journal   ReadQx   PMC

Neurogastroenterol Motil

Evaluation of abdominal gas by plain abdominal radiographs.

Plain abdominal radiographs have limited value for the evaluation of abdominal gas volume in patients with functional gut disorders.

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Interactions between symptoms and psychological status in irritable bowel syndrome: An exploratory study of the impact of a probiotic combination.

These findings suggest that the stress response is a major driver of IBS symptoms. The time course of the beneficial effect of COMBO on IBS symptoms suggests that this is achieved through a restoration of the stress response. In contrast, the time course of the effects of COMBO on anxiety and depression in IBS paralleled an anti-inflammatory effect as indicated by a reduction in circulating levels of TNF-a.

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Randomized clinical trial: A double-blind, proof-of-concept, phase 2 study evaluating the efficacy and safety of vonoprazan 20 or 40mg versus esomeprazole 40mg in patients with symptomatic gastro-esophageal reflux disease and partial response to a healing dose of a proton-pump inhibitor.

No statistically significant difference in efficacy and safety was observed among treatment groups, and vonoprazan was well tolerated. The trial is registered with the National Board of Health (EudraCT 2015-001154-14) database.

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Willingness to pay for medications among patients with Rome IV irritable Bowel syndrome.

Patients with IBS are willing to pay for medications which improve IBS symptoms. Future studies should investigate the relative importance of medication pricing, efficacy, and side effect profile among individuals with IBS.

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Reviews&Editorials

Plenty of the editorials are available as full text through the publisher website using the provided link

Am J Gastroenterol

Gender, Race, and Ethnicity Representation Among Gastroenterologists: A Review of Recent Trends.

Despite the urgency of this topic, there is a paucity of data examining trends in gender and racial/ethnic diversity among medical professionals within the field of GI. In this narrative review, we examine how ethnoracial and gender representation has changed over time at critical points along the educational, training, and career pathways in GI.

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Clin Gastroenterol Hepatol

CAN AN INSPIRATION AROUND PERSPIRATION LEAD TO AN INNOVATION IN IBD MANAGEMENT?

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Rare, Overlooked, or Underappreciated Causes of Recurrent Abdominal Pain: A Primer for Gastroenterologists.

A lack of awareness of some of the rarer causes of recurrent abdominal pain may impede diagnosis and delay effective management. This article identifies some of the key rare but diagnosable causes that are frequently missed by gastroenterologists, and provides expert recommendations to support recognition, diagnosis, and management with the ultimate aim of improving patient outcomes.

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Gastroenterology

The potential synergy of using interventional and observational data to study clinically meaningful, long-term outcomes in rare liver and luminal diseases.

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Hepatology

Now you see it, Now you don't: Estrogen Exposure and Obesity Effects on HCA Development and Regression.

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Miscellaneous

misc publications eg case reports, tools of the trade, images of the month, etc…

Am J Gastroenterol

Abdomino-phrenic dyssynergia: a narrative review.

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ACG Monograph on GI Diseases and Endoscopy in Pregnancy and Postpartum Period: An Introduction.

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Advanced Endoscopic Procedures in Pregnancy.

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Avoid iatrogenic injuries.

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Calendar of Courses, Symposiums and Conferences.

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Concluding Remarks.

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Constipation, Hemorrhoids, and Anorectal Disorders in Pregnancy.

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Endoscopy and Sedation.

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Familial adenomatous polyposis (FAP) with concomitant celiac disease - an unexpected finding on capsule endoscopy with panoramic view.

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Fecal Incontinence and Diarrhea During Pregnancy.

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Getting by With Less: How to do More With Less Staff After COVID-19?

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Heartburn, Nausea, and Vomiting During Pregnancy.

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Hyperemesis Gravidarum and Nutritional Support.

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Inflammatory Bowel Disease and Pregnancy.

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Liver Disease During Pregnancy.

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Lynch Syndrome Affecting…the Esophagus?: A Polypoid Lesion Arising from a Gastric Inlet Patch.

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Magnet-assisted diverticuloplasty in the treatment of a large epiphrenic esophageal diverticulum.

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Multiple ileal inflammatory fibroid polyps or Vanek tumours in a 30 years-old woman.

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Pemigatinib related calcification in the liver.

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Pitfalls of advanced endoscopy technologies in gastrointestinal cancer screening.

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Response to Liao et al.

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Response to Sachdeva et al.

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Rupture splenic artery aneurysm caused by pancreatic cancer.

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Surgery in Pregnancy.

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Title: Cardiac Dysfunction in the Pathogenesis of Hepatorenal Syndrome.

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Clin Gastroenterol Hepatol

Esophageal Monkeypox lesion.

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Endoscopy

A tale of two ampullas: a rare anatomic anomaly captured on video during endoscopic retrograde cholangiopancreatography.

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Acute iatrogenic gastric perforation during endoscopic ultrasound (EUS) for malignant biliary obstruction: intraoperative over-the-scope clip closure and EUS-guided biliary drainage with lumen-apposing metal stent.

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Additional irrigation tube with therapeutic endoscope to aid gel immersion endoscopic submucosal dissection.

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Breakthrough cannulation using "one forceps and one guidewire" technique in a patient with a Roux-en-Y anastomosis.

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Circumferential suture delivery method of polyglycolic acid sheets for gastric postendoscopic submucosal dissection ulcers.

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Effective application of self-assembling peptide matrix with the gel immersion technique and red dichromatic imaging for hemostasis of postendoscopic sphincterotomy bleeding.

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Fistula caused by cytomegalovirus enteritis hidden between swollen folds and detected by capsule enteroscopy.

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Single-operator cholangioscopy in a patient with prior pancreaticoduodenectomy.

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Successful hemostasis of a parapapillary diverticular hemorrhage by the retroflexion technique in the descending part of duodenum.

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Underwater endoscopic mucosal resection with submucosal injection.

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Usefulness of texture and color enhancement imaging in peroral cholangioscopy.

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Usefulness of the two-devices-in-one-channel technique for difficult bile duct intubation in patients without periampullary diverticulum.

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Gastroenterology

"Malignant" liver lesions in an incidental but high-risk patient.

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A Curious Case of Severe Proctitis.

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An Atypical Complication of Chronic Pancreatitis.

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How the Gut Feeds the Brain: A Newly Uncovered Gut-Brain Circuit for Appetite Suppression.

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Pancreatitis-associated PRSS1-PRSS2 haplotype alters T cell receptor beta (TRB) repertoire more strongly than PRSS1 expression.

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Gut

Evaluating microbial determinants of donor efficacy to translate faecal microbiota transplantation from research to clinical practice.

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Letters&Replies

Letters to the editors and authors’ replies

Gastroenterology

Response to Letter to Editor: Bile and Liver in Pregnancy: no one Split apart what God has Joined Together.

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Hepatology

Reply to the Letter to the Editor: "Predicting mortality after transjugular intrahepatic portosystemic shunt in older adult patients with cirrhosis - does novelty supplant the standard?"

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J Hepatol

Cirrhosis is an independent predictor for COVID-19 mortality: A meta-analysis of confounding cofactors-controlled data.

Pubmed   Journal   ReadQx   PMC

Expert opinion versus meta-analysis: to be or not to be?

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Reply to: "SEAL: why was this approach not effective?"

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The possible link between higher ammonia levels associated with non-alcoholic fatty liver related cirrhosis and diabetes: are we missing chronic kidney disease?

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Neurogastroenterol Motil

Intrapyloric botulinum toxin injection for functional nausea and vomiting: Just a placebo?

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